Section 410.426(a) provides, inter alia, that a miner be determined to be under a disability only if pneumoconiosis is the primary reason for his inability to engage in comparable and gainful work. Medical impairments other than pneumoconiosis may not be considered. 20 C.F.R. §410.426(a). The Board has construed this requirement to mean that the medical severity of the miner's pneumoconiosis must be stressed rather than factors of age, education, work experience or other medical impairments. Vargo v. Bethlehem Mines Corp., 1 BLR 1-347 (1977); Crawford v. Clinchfield Coal Co., 1 BLR 1-197 (1977). Additionally, the Board has held that the claimant bears the burden of proving this element. Rogers v. Ziegler Coal Co., 1 BLR 1-847 (1978); Stevens v. Director, OWCP, 1 BLR 1-386 (1978).

While Section 410.426(a) provides that pneumoconiosis must be the primary reason for the miner's inability to engage in "comparable and gainful work," in light of the claimant's general burden of proof in establishing total disability under Section 410.412 and 410.426, the primary cause requirement properly applies to the miner's ability to perform his usual coal mine work. See Fletcher v. Appalachian Coal Co., 1 BLR 1-785 (1978). A claimant can establish that pneumoconiosis is the primary cause of the miner's disability if he shows that his pneumoconiosis is, in and of itself, totally disabling. Wells v. Peabody Coal Co., 3 BLR 1-85 (1976), aff'd sub nom. Peabody Coal Co. v. Benefits Review Board, 560 F.2d 797 (7th Cir. 1977). A claimant need not prove that the miner is disabled solely due to pneumoconiosis, nor that the miner's pneumoconiosis, when weighed with all of his other impairments, is the most severe. Rather, the claimant need only establish that the miner's pneumoconiosis is sufficiently severe so as to be an independent cause of his total disability. See Burks v. Hawley Coal Mining Corp., 2 BLR 1-323 (1979); Branham v. Director, OWCP, 2 BLR 1-111 (1979); Smaroff v. Bethlehem Mines Corp., 2 BLR 1-33 (1979).

If the miner is totally disabled due to a breathing impairment and the evidence is in conflict as to the cause of that impairment, the administrative law judge must weigh the evidence, resolve the conflicts and make a finding of fact. Kurimcak v. United States Steel Corp., 2 BLR 1-75 (1979). Additionally, the administrative law judge must provide an adequate rationale supporting this determination. Rasel v. Bethlehem Mines Corp., 1 BLR 1-918 (1978). Nonetheless, the administrative law judge need not use the precise language "primary cause." Rather, the administrative law judge's finding on this issue will be deemed sufficient so long as it is equivalent to a conclusion that pneumoconiosis is the primary cause of the miner's disability. Matney v. Jones & Laughlin Coal Co., 3 BLR 1-332 (1981); Retter v. Peabody Coal Co., 1 BLR 1-957 (1978).

In determining the primary cause of a miner's disabling pulmonary or respiratory impairment, the administrative law judge may consider a miner's history of cigarette smoking, since that is a generally accepted cause of pulmonary insufficiency. Romero v. Director, OWCP, 2 BLR 1-531 (1979); Chastest v. Director, OWCP, 2 BLR 1-259 (1979). The administrative law judge may also properly reject a physician's opinion that a miner is totally disabled due to pneumoconiosis where the physician failed to consider the miner's history of cigarette smoking. Gomola v. Manor Mining & Contracting Corp., 2 BLR 1-130 (1979).

While a physician's opinion attributing the miner's impairment to smoking once had to be expressed with a "reasonable degree of medical certainty," Blevins v. Peabody Coal Co., 1 BLR 1-1023 (1979) (Blevins II), the Board subsequently held that a doctor's opinion on the issue is admissible if it constitutes a reasoned medical judgment. Blevins v. Peabody Coal Co., 6 BLR 1-750 (1983) (Blevins III). For a discussion of the Blevins tests for admissibility, see Part IV.D.3.a. of the Desk Book.

[circumstances surrounding miner's job indicative of reduced ability to perform as a result of pneumoconiosis, then continued employment may be consistent with finding of total respiratory disability] Felthager v. Weinberger, 529 F.2d 130 (10th Cir. 1976).

[finding that miner not totally disabled even though record contained qualifying pulmonary function study but also showed that miner continued to work in usual coal mine employment] Vance v. Buffalo Mining Co., 1 BLR 1-555 (1978); see also Miller v. United States Steel Corp., 1 BLR 1-438 (1978).

[Sixth Circuit affirmed finding that claimant's back impairment was primary cause of disability as evidence in conflict with respect to whether miner was totally disabled from any black lung ailment; "[w]e do not know how a claimant can be totally and permanently disabled more than once."] Gastineau v. Matthews, 577 F.2d 356, 360 (6th Cir. 1978).

[where record shows total disability due to breathing impairment, and there is no evidence attributing impairment to any cause other than pneumoconiosis, pneumoconiosis may be presumed the primary cause of disability] Kurimcak v. U.S. Steel Corp., 2 BLR 1-75 (1979); Collins v. United States Steel Corp., 1 BLR 1-654 (1978).

[where record contains substantial evidence supporting finding of total disability under Section 410.424, adjudicator must make clear finding as to what specific evidence rebuts finding of total disability]. Call v. Director, OWCP, 2 BLR 1-146 (1979); see also Williamson v. United States Steel Corp., 2 BLR 1-470 (1979).

[adjudicator must determine whether comparable work is gainful; finding that claimant's work on parents' farm gainful work not supported by substantial evidence where claimant testified he worked only on occasional basis and to aid his parents who were in poor health] Young v. Harper Valley Coal Co., 2 BLR 1-167 (1979).

[medical report failed to sufficiently specify miner's current limitations due to pneumoconiosis to permit comparison with requirements of former coal mine work or comparable and gainful work, therefore failing to establish total disability] Williamson v. United States Steel Corp., 2 BLR 1-470 (1979).

[finding of no total disability affirmed as claimant continued to work effectively in usual coal mine job nearly three years after qualifying blood gas study] Williamson v. United States Steel Corp., 2 BLR 1-470 (1979); see also Kinnick v. National Mines Corp., 2 BLR 1-221 (1979).

[abnormal EKG will not establish total disability due to pneumoconiosis pursuant to Appendix unless it satisfies one of the specific criteria of disability listed therein] Childress v. Harman Mining Corp., 2 BLR 1-644 (1979).

[Board overturned precedent established in Strako v. Zeigler Coal Co., 3 BLR 1-136 (1981), whereby nonconforming ventilatory studies may not be considered when weighing evidence for invocation pursuant to 20 C.F.R. §727.203(a)(2); while adjudicator must generally consider such evidence in accord with quality standards specified in Section 410.430, qualifying study that is non-conforming retains its validity and may be weighed along with conforming studies where it fails to satisfy quality standards only because it lacks a statement of cooperation and comprehension, which can only improve values of an already non-qualifying test] Crapp v. United States Steel Corp., 6 BLR 1-476 (1983).

[reversal of award of benefits holding claimant's present job driving truck comparable and gainful employment even though not as arduous physically; comparing levels of exertion one factor to be considered in determining disability, but not dispositive] Kane v. Director, OWCP, 6 BLR 1-791 (1984).

[adjudicator properly found total disability based on medical opinion stating he could perform light manual labor, where claimant's usual coal mine work found to be "heavy"] Meeks v. Director, OWCP, 6 BLR 1-794 (1984).

["age" is factor in considering total disability under Section 410.426(d) only when adjudicator is analyzing miner's ability to do comparable and gainful work after its been established that miner unable to do usual coal mine work] Kolesar v. The Youghiogheny & Ohio Coal Co., 760 F.2d 728, 7 BLR 2-211 (6th Cir. 1985); see also Warmus v. Bethlehem Mines Corp., 1 BLR 1-182 (1977).

[adjudicator may consider cumulative effect of all relevant evidence in resolving issue of total respiratory disability even though this evidence may be insufficient when considered by itself] Burnett v. Director, OWCP, 7 BLR 1-781 (1985); see also Allen v. Union Carbide Corp., 8 BLR 1-393 (1985).

DIGESTS

The Board affirmed the administrative law judge's uncontested finding that claimant had established a prima facie case of total respiratory disability based on a qualifying pulmonary function study pursuant to 20 C.F.R. §410.426(b). Board remanded case to administrative law judge to properly weigh the comparability of skills, abilities and physical exertion between the miner's current employment and his previous job as a coal loader for purposes of determining whether claimant's prima facie case of total disability had been defeated by proof that the miner was engaged in comparable and gainful work. 20 C.F.R. §§410.412(a), 410.424(a), 410.426(a). Caudill v. Director, OWCP, 9 BLR 1-174 (1986).